Unfortunately, the hospital case worker is no longer a case worker. She's still there, but is doing therapy now, not case work. She was nice enough to email me back various contacts and phone numbers and information she had, but no, I couldn't ask her to deal with the insurance company. But the ambulance person said she'd be willing to get on a 3-way call with me and cigna. I'm waiting to hear back from the cigna case worker. Glad it sounds like yours will work out.

So far:

Hospital says that Cigna said "use company X for ambulance because it's in-network, so no authorization is needed." But no actual record of this.

Ambulance co says Cigna rejected claim because they don't cover transport at all. Cigna told me that at first, but then said it wasn't covered because there was no auth. Ambulance co is checking to see if auth is needed with cigna.

I have a call into the case worker at cigna who was in charge of this to see what the actual reason for the rejection is and to see what she says about needing an auth. But I've dealt with her before and she's a total idiot. (She's the one who tried to tell me they don't cover any RTCs at all in my state, which isn't true.) So we'll see.

Bottom line is that there is no way I could have gotten authorization--I wasn't involved. A bed opened up at hospital 2 and hospital 1 arranged for transport.  Even if I had said "hey wait, let me call cigna and make sure all this is covered" I KNOW the hospital case worker would have said don't worry, we've taken care of all that and it's covered. I know she would have said that. She was constantly telling us don't worry about insurance. We are dealing with that.

Oh no! 

Yes, they should have done that.

When I called my insurance company, the ambulance company hasn't called them.  I'll call this coming week. I was sick and last week I had so much to do for my mom. But I'll get back to it this week. Not looking forward to talking with that man again. Really not.

You're darn tootin' right.

Actually, I know I've seen on twitter in the last few months one of the allergy docs post something about a study of ERs and anaphylaxis.  About protocol a d it NOT being followed. I was trying to find that. Clearly my ER follows protocol fairly well.

Yesterday I called my insurance to see if things had been faxed. Nope.

Ugh.

This is where your language in all communications needs to be VERY FIRM.

You have them, but I get you want them to be educated as to def of anaphylaxis.

Get your bill paid first via insurance.

Make the education as to anaphylaxis secondary -- once you have primary care doc and/or allergist who might help.

Looks like FARE needs to be onto things once dust has settled -- bring this whole situation to their attention and get them to do campaign as to def of anaphylaxis . . . not just for epi treatment but for standard insurance coding . . . after appropriate care!

Be sure you miss no deadlines for any requests for review and/or disputes of nonpayment so far as your insurance.  Missing any deadlines/gates is typically non-negotiable.

 A couple of things from a friend who used to do health ins....

If the emt isn't responsive, talk to the emt's suprerior in regards to getting it coded differently - any code that shows you couldn't have used other transportation will work (i.e., you were not using the ambulance as a cab)
Copy of dr's orders about what to do if you epi
Copy of er's diagnosis and the fact they re-epied you

Holy cow that is a lot.

Its $45 here if its medically necessary and $240 if its not.